Severity of meningococcal infections is related to anthropometrical parameters

Background: Invasive meningococcal infections remain an important cause of death in children. Malnutrition has been classically associated with increased severity of infectious diseases. However, lethal meningococcemia in clinically malnourished children was extremely rare in our experience. Our purpose was to determine whether there exists an association between nutritional status and outcome in children with invasive meningococcal infection. Methods: We performed an observational study and prospectively determined anthropometrical parameters in 127 one-month to 4 year-old children seen in our inpatients facilities with invasive meningococcal infection from August 99 to May 2004. Severity and survival were the clinical end points analysed. Results: Severe cases had higher weight for age (1.02 vs. -0.19) and height for age (1.12 vs. -0.58) Z-scores than non-severe cases. Non-survivors had higher weight for age (0.90 vs. -0.16) and height for age (0.73 vs. -0.57) Z-scores than survivors. Clinical and biological variables usually accepted as predictors of high mortality or severity in patients with meningococcal infection were not significantly associated with weight for age and height for age Z-scores. Conclusion: In the present prospective series of children with invasive meningococcal disease, severity and death were linked to anthropometrical parameters and they seemed to be associated with a very good nutritional status, which confirmed our previous uncontrolled observations.